Cervical pregnancy successfully treated with US-guided intra-amniotic Methotrexate injection after the failure of IM Methotrexate: a case report

Abstract

Background: Cervical pregnancy is a rare ectopic pregnancy caused due to implantation of the ovum in the endocervical canal. In the past, early diagnosis for such condition was not possible as a result this condition often was presented lately to the clinics with life-threatening hemorrhage that frequently required a hysterectomy. At present, there has been tremendous development in the medical field which led to early diagnosis of ectopic pregnancy using ultrasonography (U/S) and sensitive serum 0-hCG assay. Such techniques allow a more conservative therapeutic approach resulting in low morbidity and mortality rates. Case presentation: A 38-year-old woman, gravida 2, para 1, was presented with painless vaginal bleeding. Early cervical pregnancy was diagnosed using transvaginal U/S. Intramuscular methotrexate (IM MTX/) therapy was started without success an intra-amniotic injection of MTX was performed under U/S guidance. Pregnancy was terminated successfully, without complications. Conclusions: Local MTX is an effective and safe method.